NPI 1003044066

Timothy Carl Blake

Practitioner Counselor Winston Salem, NC

Practice location

Address: 725 Highland Ave, Winston Salem, NC 27101-4206
Phone: (336) 607-8523
Mailing address: 284 Executive Park Dr Suite 100, Concord, NC 28025-1831

Registered specialties

Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101Y00000X

Other Counselor providers in North Carolina →

Registry record

NPI: 1003044066
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jun 2009
Record last updated: 29 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.